Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364830081
Report Date: 04/03/2018
Date Signed 04/03/2018 03:33:28 PM


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/23/2018 and conducted by Evaluator Jazelle Neal
COMPLAINT CONTROL NUMBER: 12-CC-20180223123456
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364830081
ADMINISTRATOR:SANDRA FRENIFACILITY TYPE:
840
ADDRESS:13615 BEAR VALLEY ROADTELEPHONE:
(760) 949-8539
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY:38CENSUS: 26DATE:
04/03/2018
UNANNOUNCEDTIME BEGAN:
03:14 PM
MET WITH:Sandra FreniTIME COMPLETED:
03:47 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Medication - Staff failed to administer medication as prescribed to child.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Neal met with Center Director, Sandra Freni for the purpose of delivering findings for a complaint investigation for the above allegation. During this investigation, LPA observed children's supervision record for that day, obtained copies of the Medication log, text messages between parent and acting Assistant Director, child's health history (LIC 702), medical orders from the child's physician, consent for Emergency Medical Treatment (LIC 627B), Medication Authorization and Kindercare's Medical Services Plan. LPA also conducted interviews with staff, parent and child.

Based on the interviews conducted and information provided, the allegation has been deemed unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged abuse occurred. No citations were issued during this investigation.
Exit interview was conducted and a copy of this report was given to the director.
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle NealTELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2018
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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